当前位置： SCI文献检索 > SPINE期刊下所有文献 > Results of lumbar pedicle subtraction osteotomies for fixed sagittal imbalance: a minimum 5-year follow-up study.

Results of lumbar pedicle subtraction osteotomies for fixed sagittal imbalance: a minimum 5-year follow-up study.

Abstract：

STUDY DESIGN:Retrospective study. OBJECTIVE:To report results at a minimum 5 years after pedicle subtraction osteotomy for fixed sagittal imbalance. SUMMARY OF BACKGROUND DATA:No one has reported results of pedicle subtraction osteotomies with a 5- to 8-year follow-up. METHOD:Thirty-five consecutive patients with sagittal imbalance (29 females/6 males, average age at surgery, 53.1 years) treated with lumbar pedicle subtraction osteotomies (1 at L1, 13 at L2, 20 at L3, and 1 at L4) at 1 institution were analyzed (average follow-up, 5.8 years; range, 5-7.6 years). Radiographic and clinical outcomes analysis was performed. RESULTS:There were no significant regional radiographic changes between 2 years postoperative and the ultimate follow-up (proximal junctional change, P = 0.30; thoracic kyphosis, P = 0.38; and lumbar lordosis, P = 0.84), although many patients did demonstrate an increasingly anterior C7 sagittal plumb with time. Ten pseudarthroses (29%) occurred in 8 patients and were revised between 2 and 5 years postoperative. There were no pseudarthroses at the osteotomy level (9 at the thoracolumbar junction, 1 at the LS junction), but at the levels added to the previous fusions. There was no degradation in Oswestry and Scoliosis Research Society (SRS) outcome scores between 2 years postoperative and ultimate follow-up (P = 0.23 and 0.90, respectively). Patients reported very good satisfaction (87%), good self-image (76%), good function (69%), and fair pain subscales (66%) at ultimate follow-up. Sagittal vertical axis <8 cm at ultimate follow-up was significant for better SRS outcomes scores (P = 0.038). Eight patients with revised pseudarthroses did not demonstrate poorer SRS outcomes scores (P = 0.52). Those 8 patients were queried after their pseudarthrosis revision surgery. CONCLUSION:Pedicle subtraction osteotomy can provide satisfactory clinical and radiographic outcomes for patients with a minimum 5-year follow-up despite needing pseudarthrosis revision and some component of increasingly positive sagittal vertical axis between 2 years and 5 to 8 years of follow-up. The level of patient satisfaction and self-image subscales were high after more than 5 years of follow-up. Restoration and maintenance of sagittal vertical axis <8 cm were important to the ultimate sagittal reconstruction.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Kim YJ,Bridwell KH,Lenke LG,Cheh G,Baldus C

doi

10.1097/BRS.0b013e31814b8371

subject

Has Abstract

pub_date

2007-09-15 00:00:00

pages

2189-97

issue

eissn

0362-2436

issn

1528-1159

pii

00007632-200709150-00008

journal_volume

pub_type

杂志文章

在线工具

Results of lumbar pedicle subtraction osteotomies for fixed sagittal imbalance: a minimum 5-year follow-up study.